most recent update and new medication for HF

I wouldn't be disappointed with your progress

by Gemita - 2021-10-18 06:52:03

Hello Tulp,

https://www.berkshirewestccg.nhs.uk/media/5218/poc-clindoc-066-dapagliflozin-hf-protocol.pdf

https://www.nice.org.uk/guidance/ta679/documents/final-appraisal-determination-document

Despite your disappointment with your ejection fraction (EF), you are still doing well and I would be confident that your doctors are on the right track and you too.   I think we all worry too much about those percentages which “by themselves” may not mean a great deal.  These percentages have to be assessed with other test results and as your cardiologist quite rightly said, “The bloodwork matters a lot too” and “your heart is fine now”.  I would be extremely encouraged by those remarks. 

I notice your pro-BNP levels are normal and since levels go up when heart failure gets worse, I would say this is a very good sign.  Clearly your EF is stable and that is important.  Some patients I believe see good results immediately with CRT treatment, others need more time and a combination of treatments to notice any improvement.

Importantly, how do you feel now?  Do you feel better with the “resynchronisation therapy” you received in February 2021?  I hope you have not had any defibrillator shocks.

Dapagliflozin I see has fairly recently been approved for treatment of symptomatic chronic heart failure with reduced EF in adults with and without Type 2 diabetes.  It is a sodium-glucose co-transporter-2 (SGLT2 inhibitor).  It is used as an “add-on to standard care meds” like ACE inhibitors, ARBs for example.  It is only used on the advice of a heart failure specialist and needs to be monitored closely.   Please see links above Tulp for further research if you wish.  Evidence shows that Dapagliflozin may lower the risk of dying from heart disease and reduces the likelihood of hospitalisation or an urgent outpatient visit because of heart failure.

As always, I hope for the very best for you

EF

by ROBO Pop - 2021-10-18 12:19:30

That's just a number that dr use to gauge progress or digression, and you really just need to focus on how you feel, that's what's important. They've been telling me for years the end is nigh and insist I pay up front for my visits, yet 15 years later and I'm still here annoying everyone. I might add, echos are subjective and two different people reading the same data can come up with widely differing answers. What you want is the same person doing the echo everytime.

 I might also add that a 40% EF is condidered a mild case with 50 -75 being normal. ( some say 55 - 75). Whst is notmal for one person msy not be for another. My EF is hovering at ...OMG how can I be alive - yet, it doesn't bother me. I enjoy every day.

sure, I know

by Tulp - 2021-10-19 09:15:54

But when I came to the hospital last year, they seemed to be the most  worried about my EF (15%)

I felt quite OK actually ,( just short of breath and weird noises coming from my lungs) but one doctor said I was in a "pre-mortem" state...

So I was focusing on getting my EF up.

I need surgery, and the anesthesiologist won't put me to sleep if I m not high enough.

I had to have a colonoscopy under hypnose because of that !

I'll tell you, it was not very comfortable, but I did it...

They are now considering taking away my gallbladder soon. Has been aching for some time, and I have gallbladder stones. I don't want to undergo that one under hypnose !!